Merhaba, Ben su anda Amerikadayim ve sorumu yanitlamaniz benim icin cok onemli. Burada saglik imkanlari hem sinirli hem pahali. Amerikadaki dr. bana prednizon verdi, isitme kaybi icin gunde 6 adet 10mg bu doz bana cok fazla geldi. Bu ilacin gebelikte olumsuz etkisi varmidir? Cok tesekkur ederim Saygilarimla.
Su anda gebe misiniz ve gebe iseniz kac haftaliksiniz, bunu yazmamissiniz. eger gebe degilseniz ve gebe kalacaksaniz biraz daha korunmaya devam etmenizi onerecegim. bu ilaci kullanmanizin ilerde gebe kalma potansiyelinze bir engeli yoktur. eger gebe iseniz; cok kesin zarari olmamakla birlikte bebekte yarik damak ve dudak yapabilme olasiligi vardir (ilk aylarda). ancak sizinki gibi annenin bu tur onemli ve acil sorunlari oldugunda rahatlikla kullanilabilir. cunku sizin durumunuzda bu etkili ve yuz guldurucu bir tedavidir. ancak daha ilerki aylarda bu tur etki dahi pek gorulmez ve onemli bir zarari gosterilememistir. asagida, rahatlamaniz icin, ingilizce bir kitabimizdan alinti gonderiyorum, umarim hepsini okuyabilirisniz ____________________________________________________________________________ drugs in pregnancy & lactation: prednisonecorticosteroidb fetal risk summary prednisone is metabolized to prednisolone. there are a number of studies in which pregnant patients received either prednisone or prednisolone (see also various antineoplastic agents for additional references) (1-14). these corticosteroids apparently have little, if any, effect on the developing fetus. in a surveillance study of michigan medicaid recipients involving 229,101 completed pregnancies conducted between 1985 and 1992, 143, 236, and 222 newborns had been exposed to prednisolone, prednisone, and methylprednisolone, respectively, during the 1st trimester (f. rosa, personal communication, fda, 1993). the number of birth defects, the number expected, and the percent for each drug were 11/6 (7.7%), 11/10 (4.7%), and 14/9 (6.3%), respectively. specific details were available for six defect categories (observed/expected): cardiovascular defects (2/1, 2/2, 3/2), oral clefts (0/0, 0/0, 0/0), spina bifida (0/0, 0/0, 0/0), polydactyly (0/0, 0/1, 0/1), limb reduction defects (0/0, 0/0, 1/0), and hypospadias (1/0, 0/1, 1/1), respectively. these data do not support an association between the drugs and congenital defects, except for a possible association between prednisolone and the total number of defects. in the latter case, other factors, such as the mother's disease, concurrent drug use, and chance, may be involved. immunosuppression was observed in a newborn exposed to high doses of prednisone with azathioprine throughout gestation (15). the newborn had lymphopenia, decreased survival of lymphocytes in culture, absence of igm, and reduced levels of igg. recovery occurred at 15 weeks of age. however, these effects were not observed in a larger group of similarly exposed newborns (16). a 1968 study reported an increase in the incidence of stillbirths following prednisone therapy during pregnancy (7). increased fetal mortality has not been confirmed by other investigators. an infant exposed to prednisone throughout pregnancy was born with congenital cataracts (1). the eye defect was consistent with reports of subcapsular cataracts observed in adults receiving corticosteroids. however, in this case, the relationship between the cataracts and prednisone is doubtful because of the lack of similar reports. in a 1970 case report, a female infant with multiple deformities was described (17). her father had been treated several years before conception with prednisone, azathioprine, and radiation for a kidney transplant. the authors speculated that the child's defects may have been related to the father's immunosuppressive therapy. a relationship to prednisone seems remote because previous studies have shown that the drug has no effect on chromosome number or morphology (18). high, prolonged doses of prednisolone (30 mg/day for at least 4 weeks) may damage spermatogenesis (19). recovery may require 6 months after the drug is stopped. prednisone has been used successfully to prevent neonatal respiratory distress syndrome when premature delivery occurs between 28 and 36 weeks of gestation (20). therapy between 16 and 25 weeks of gestation had no effect on **** ratios (21). in summary, prednisone and prednisolone apparently pose a very small risk to the developing fetus. the available evidence supports their use to control various maternal diseases. breast feeding summary trace amounts of prednisone and prednisolone have been measured in breast milk (22-25). following a 10-mg oral dose of prednisone, milk concentrations of prednisone and prednisolone at 2 hours were 26.7 and 1.6 ng/ml, respectively (22). the authors estimated the infant would ingest approximately 28.3 µg in 1000 ml of milk. in a second study using radioactive-labeled prednisolone in seven patients, a mean of 0.14% of a 5-mg oral dose was recovered/l of milk during 48–61 hours (23). in six lactating women, prednisolone doses of 10–80 mg/day resulted in milk concentrations ranging from 5% to 25% of maternal serum levels (24). the **** ratio increased with increasing serum concentrations. for maternal doses of 20 mg once or twice daily, the authors concluded that the nursing infant would be exposed to minimal amounts of steroid. at higher doses, they recommended waiting at least 4 hours after a dose before nursing was performed. however, even at 80 mg/day, the nursing infant would ingest